Lice, Ticks, and Other Icks!

By AM Northwest Staff

If you actually do go camping over spring break, your kids may bring home a souvenir you didn't bargain for!

We had Pediatrician Dr. George Bengston tell us what to do about lice, ticks, or worse.

Advice:

Head Lice

Types of lice (slide w/ three types):

    1. Body louse
    2. Pubic louse "crabs"
    3. Head louse

Basic biology:

  • Very adaptable creature
  • Children affected most commonly
  • Spread by interaction w/ playmates and physical transfer from clothing, combs,
  • towels, headphones, beds
  • Black kids affected less often – no one knows why
  • Eggs, attached to hair shafts, are called "nits" (see slide of nit)
  • Lice do NOT jump, fly, or travel on pets

Clinical signs

  • Itching of scalp, neck, ears due to allergic reaction to louse saliva
  • Visualization of lice or nits (see slide of nits on hair)
  • Enlarged lymph nodes
  • Unexplained skin infections

Diagnosis

  • Finding of lice or nits
  • Use of nit comb (demonstrate?)
  • Nits very near the scalp more suspicious for active infection
  • Treatment
  • Topical insecticides
  • Permethrin (Nix) or Pyrethrins (Rid, A-200, Pronto, Clear)
  • Malathion (remember the fruit fly?)
  • Lindane (Kwell) – toxicity, especially if left on too long
  • Wet combing
  • Alternative to insecticides in kids under age 2
  • Vinegar or olive oil every three or four days for two weeks after lice found
  • Oral agents
  • Septra (oral antibiotic) can be used in combination with above insecticides
  • Physical agents
  • Cetaphil cleanser/"Nuvo lotion" smothers lice? – needs further study
  • (Will try to find a bottle of this stuff to show)
  • Treatment failures
  • Usually due to improper use of product and/or continued exposure
  • Genuine resistance is becoming a factor
  • Changing from one product to another usually works
  • Return to school policies
  • "No-nit" policy probably overkill (nits can persist after treatment)
  • Schools can respond to outbreaks by segregating hats/coats/etc.
  • Household measures
  • Examine (but do not necessarily treat) household members
  • Treat bunkmates
  • Wash clothing, furniture, or carpeting which has been in contact w/ infested head
  • Lice do not usually survive more than 48 hours off the host, so bagging/isolating
  • bedsheets/pillowcases/stuffed animals/etc can do the trick

TICKS

  • Prevention
  • Inspection after outdoor adventures
  • Removal
  • Manual removal w/ tweezers
  • "Smothering" type treatments not generally effective

After-care

  • Gentle cleansing and observation for signs of infection

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